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Evaluation Overview

Peripheral nerve disorders are complicated:

• Usually in surgery it’s pretty easy to figure out what is broken.
• In peripheral nerve disorders there is a challenging diagnostic dilemma. 
• There is no single correct treatment plan, with many options available.

This section will take you through the history and physical examination of patients with peripheral nerve disorders.  The overall evaluation strategies are reviewed:

• First listen to and look at the patient carefully.
• Let the patient tell you their story of the injury/accident/etc.  This gives you an idea of the emotional impact, guilt, anger and many other issues that you need to take into consideration.
• Carefully consider your diagnosis before ordering diagnostic testing.
• In closed and gunshot wound injuries, careful and frequent evaluations over time are critical.
• Finally, make a treatment plan that is biopsychosocial in nature – take all aspects of the patient and the disorder into consideration.

Other sections to review:

• Understanding the pathophysiology of nerve injury is critical to diagnosis and treatment. Consider reviewing the section involving nerve pathophysiology.
• Examination by anatomic region (working from the shoulder or hip distally) or by specific nerve is presented in detail within this section.  Although not all patients need this type of full exam, knowing all the components helps ensure that nothing is missed.
• A broad review of the different types of management options – including surgical treatments – is included, but the step-by-step surgical tutorials may be found instead in the surgical options section.